Quality of Care in Nursing Homes: The Relationship Between State Level Health Care Policy and

Quality of Care in Nursing Homes: The Relationship Between State Level Health Care Policy and

Abstract:

Quality of Care in Nursing Homes: The Relationship Between State Level Health Care Policy and

Conference Sponsor:

Midwest Nursing Research Society

Conference Year:

2005

Author:

Gorski, Mary

P.I. Institution Name:

Loyola University Chicago

Title:

Assistant Professor

Contact Address:

College of Nursing, 6525 N. Sheridan Road, Chicago, IL, 60626, USA

Contact Telephone:

(773) 508-2894

Email:

gorski@gu.gonzaga.edu

Nursing home care is governed by institutional, state, and federal level policies. Despite the myriad number of policies and complex federal, state, and local enforcement system, there continues to be evidence of poor quality of care in some nursing homes in the United States. This study examined the relationship between selected state level health care policies in Washington, Idaho, and Oregon and quality measures derived from the nursing home minimum data set (MDS). The concept of quality was examined using KingÆs social, interpersonal and personal systems framework. A descriptive policy framework was developed using public access data sources for three state policies; Medicaid funding formulas, frequency and rigor of state nursing home surveys, and mandatory professional nurse staffing levels. Two archival data sets were chosen to define the variables of interest. The Provider of Service (POS) data contains the facility variables; size of facility, profit/nonprofit status, and rural/urban status of facilities. The Geriatric Minimum Data Set (MDS) contains resident data and was used to define resident age, gender, and acuity and the four outcome variables; pressure sore prevalence, prevalence of infections, greater than nine medications, and decline in late loss activities of daily living (ADLs). All nursing home residents excluding residents under sixty five years of age and those funded by Medicare for acute rehab in Washington, Idaho, and Oregon, in the year 2002 were included in the study. A statistical model was developed to examine the interaction between variables. However, further delineation of selected variables is necessary before use of this model. Preliminary descriptive examination of the variables delineated revealed Washington state had two of the three state policies most likely to support quality, yet three of the four resident outcomes indicated the poorest quality of care when comparing across the three states. Although some of the variables are not yet definitive for comparison, the preliminary results indicate compelling patterns worthy of further exploration. (Poster Presentation)

Full metadata record

Quality of Care in Nursing Homes: The Relationship Between State Level Health Care Policy and

en_GB

dc.identifier.uri

http://hdl.handle.net/10755/161158

-

dc.description.abstract

<table><tr><td colspan="2" class="item-title">Quality of Care in Nursing Homes: The Relationship Between State Level Health Care Policy and</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Gorski, Mary</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Loyola University Chicago</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">College of Nursing, 6525 N. Sheridan Road, Chicago, IL, 60626, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(773) 508-2894</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">gorski@gu.gonzaga.edu</td></tr><tr><td colspan="2" class="item-abstract">Nursing home care is governed by institutional, state, and federal level policies. Despite the myriad number of policies and complex federal, state, and local enforcement system, there continues to be evidence of poor quality of care in some nursing homes in the United States. This study examined the relationship between selected state level health care policies in Washington, Idaho, and Oregon and quality measures derived from the nursing home minimum data set (MDS). The concept of quality was examined using King&AElig;s social, interpersonal and personal systems framework. A descriptive policy framework was developed using public access data sources for three state policies; Medicaid funding formulas, frequency and rigor of state nursing home surveys, and mandatory professional nurse staffing levels. Two archival data sets were chosen to define the variables of interest. The Provider of Service (POS) data contains the facility variables; size of facility, profit/nonprofit status, and rural/urban status of facilities. The Geriatric Minimum Data Set (MDS) contains resident data and was used to define resident age, gender, and acuity and the four outcome variables; pressure sore prevalence, prevalence of infections, greater than nine medications, and decline in late loss activities of daily living (ADLs). All nursing home residents excluding residents under sixty five years of age and those funded by Medicare for acute rehab in Washington, Idaho, and Oregon, in the year 2002 were included in the study. A statistical model was developed to examine the interaction between variables. However, further delineation of selected variables is necessary before use of this model. Preliminary descriptive examination of the variables delineated revealed Washington state had two of the three state policies most likely to support quality, yet three of the four resident outcomes indicated the poorest quality of care when comparing across the three states. Although some of the variables are not yet definitive for comparison, the preliminary results indicate compelling patterns worthy of further exploration. (Poster Presentation)</td></tr></table>

en_GB

dc.date.available

2011-10-26T23:16:50Z

-

dc.date.issued

2011-10-17

en_GB

dc.date.accessioned

2011-10-26T23:16:50Z

-

dc.description.sponsorship

Midwest Nursing Research Society

en_GB

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